ER s03e14 Episode Script

Whose Appy Now?

Previously on ER I killed a man and nobody around here seems to give a damn! What's up? Are you pregnant? Want to go out sometime? Mark Greene. Heather Morgan. It's your job to assist me. It's called "physician assistant." Are you always this arrogant, or is it me? I've been suspended. Before, you'd have ripped my lungs out for going to another surgeon. Now you don't care about yourself or your reputation. Knock, knock. Who's there? - Me. You want some company? - Sure. Nick! Nick! Get out of here, Nick. - Sorry about this. Nick, come on. - That's okay. - Sorry. I'll be right back. - It's okay. Hey, get out of here! Please /eave a message at the tone. Hey, sweet pea. Out of bed, sleepyhead! Hi, Polly. No, no. I was just about to call you. Dinner tonight? Yeah, that sounds great. About 8? Mark, you ran out of shampoo. Yeah. It's on the shelf. I gotta go. Bye-bye. Who was that? That was a doctor. We got a staff meeting tonight. We have basketball tickets. - I thought that was tomorrow night. - No, it's tonight. Remember? But, you know if you really can't make it I think I can postpone. What have you got? City bus vs. Drunk pedestrian. Fractured pelvis abdominal trauma. Want to take this? Lavage is positive. Start with an ex-lap. I haven't got your paperwork. Go. - Benton said he'd do it. - It hasn't arrived yet. - It's on its way. - You can't begin a new rotation until he's signed off on the last one. What do I do? Until I get your evaluation, nothing. - Dr. Hicks, please. - Find Benton. Get your paperwork. Until then, you're grounded. - Malik, let it go. - Come on, man! - You was out of control. - It was offensive. - You charged. - Lf I'm up in the air, I need room. So you're saying you get up so high that I have to slide right up under you. - So white man can jump. - That's right. - They just can't land. - That's why we don't do it. - Oh, man. You want me to carry you? - Leave me alone. Hey, Kerry. Doug, that's not funny. I sprained my ankle. We got a kid choking! - On what? - I don't know. - How long ago? - About 10 minutes ago. - He's not breathing. Go, go, go. - Let's go. Take care of the dad, please. McGill forceps. Someone call Respiratory. Set up a vent. Let me borrow this. - Take 500 cc's saline on a Buretrol. - Come on. He'll be all right. Get him on a monitor. What's in there? Looks like a jacks ball. Pulse ox is 80. - He's cyanotic. - Can you reach it? No, it's wedged in there. He's in V-tach. - Get him 15 of lidocaine. - I'll shock him. - Keep the lidocaine onboard. - Clear. - Everybody off. - Clear! - Still in V-tach. - Again. Here we go. Clear. Here we go. Prep for a trach. Get me a 16-gauge needle on a syringe. - Trach kit. - Hang on just one second. Let me try this. Trach tray! What are you doing? I'm trying to boost the jack ball up. - I can feel it. - This kid needs an airway. Get the forceps. I've got a line. I can feel the ball. It's moving. I almost got it. Did you get it? - I got it. - All right, good! Pede's on their way. Is he breathing? Yep, he's breathing. What on earth made you think to do that? - Peter! - Yeah, yeah. I've been calling for days. Where you been? Been busy. - This place is a mess. - I've been working long hours. You feeling all right? - I'm just a little tired, is all. - You look terrible. I saw Carla yesterday. She's put on weight. You notice? She's pregnant. How could you be so stupid? Are you gonna marry her? I don't know. Be a father to your child? She's not good enough for you? - I didn't say that. - What's the problem? Don't walk away from me. Hey, look. You don't have to do this alone. You've got family. People who care for you. Look, Jackie, I know. I'll handle it. I'll take care of it. How? I don't know. I gotta get dressed for work. Damn. - When do you get off the cane? - A week. How'd you get two dates on the same night? Scheduling mix-up. Any suggestions? Dinner with one, drinks with the other. I think they're both expecting the works. Who do you like more? - Well, Heather's a lot of fun. - Fun's good. Polly, she's very spiritual. Spiritual like what? Like crystals or something? - Heather's got Bulls tickets. - Bulls! Say no more. Yeah, you're right. I'll call Polly. I'll make up an excuse and go out with her tomorrow. You're playing with fire here. I can juggle. Women can smell deceit. You ought to know. Those days are long gone, my friend. So what do you do now? Give advice. - The form was very confusing. - Evidently. What's going on? Haleh's playing nurse manager while Carol's away. I ordered 12 emesis basins. She ordered 12 gross. Anybody seen our paychecks? - Ask your friendly nurse manager. - They always come in by noon. Hey, did you guys see this memo from Dr. Fischer? He wants to swab and culture everyone for resistant staph. What's this about? Eight patients got staph. They think we're spreading it. - Any idea who? - Could be anyone. You, me Jerry, get these boxes out of here. You haven't filled this out. The evaluation I need to transfer. - Put it in my box. - I can't operate. - Leave it in my box. - No. Do it now. "Satisfactory work"? Thanks for your time. - What is it? - 28-year-old female. Multiple stab wounds to the chest, arm. This is my case! - Looks surgical. - I'll page you. There's plenty for everyone. Superficial lacerations. Deep, penetrating wounds. I'll get the bloods. Spin the crit. Sounds like a pneumo. - Chest-tube tray. - I need a tray too. Why don't you work together? Doyle can suture. You first. Give Carter 4.0 nylon. Who'll put the tube in? I will. Trouble in the sandbox? I'd like to put in a chest tube. Surgery's always hogging our procedures. I agree. Dr. Doyle, you do it. But I've got more experience, right? Dr. Benton? Ask Dr. Hicks. Well, you're in luck. She has bilateral pneumothoraces. You can each put one in. - I'll take this side. - Fine. - Sorry. - Peter, are you okay? I like to make a subcutaneous tunnel to avoid an air leak. That's nice. Where'd you learn that? I don't remember. Kerry, you got this? Are you sure you're okay? Just a little indigestion. Try to avoid hitting the intercostal bundle. - It's a common intern mistake. - For surgical interns. Mine's in! How're you doing over there? This says that 40% of doctors don't wash their hands between patients. No kidding. And medical personnel pick their noses three times an hour. - Many interns bathe twice a week - I don't want to be that well-informed. Doug, we've got a sick kid out front. All right. Nice technique. Could I interest you in some detective work? I'm tracking the culprit that's been spreading the staph. Good luck. I could really use your help. It's not an attractive proposition. We both know where staph comes from. Not washing their hands after using the bathroom. How will you flush them out? Carefully. Very carefully. He can't breathe. He's got cystic fibrosis. - His name? - Jad Heuston. Jad, hang in there. We're gonna fix you right up. - What's your name? - Katy Reed. - How old is he? - He's 19. - Has he been here before? - No. We live in Racine. - What were you doing here? - We were visiting. A kid this sick shouldn't be traveling. Get me a CBC, portable chest and O-2. Ten liters, please. Pulse ox is bad. 82. He's coughing up blood! He's got rales and he's breathing bilaterally. - Bronchodilator? - Yeah. Give me 5 mgs of nebulized albuterol and 200 of aerosolized tobramycin. Pulse ox is down to 78. Heart rate's 130. Let's intubate him. - We can't wait. - He doesn't want to. - Does he have a DNR order? - I think so. Yes, he does. If he's DNR, we can't tube him. He'll die if we don't tube him. Jad, please. Please don't leave me. Who's his doctor? Dobry. Something like that. Lydia, will you call Dr. Dobry in Racine? Call about the DNR order. Find out now, please. One, two, three. - Mr. Papillion? - One. Yes? Three. One, two, three. - I'm Dr. Greene. What's the problem? - Busy. - Page Psych? - On the way. Would you like me to give you something to relax? - Got any other ideas? - Well, I'm thinking. Hey, Archie. Psych consult? You stopped taking your medication, didn't you? Nina Pomerantz. Mark Greene. He's one of our regulars. Archie, snap it! Thanks. - That's amazing. - Basic behavior therapy. - Would it work on my daughter? - What's her problem? She started sucking her thumb when my wife and I got divorced. My 6-year-old wet the bed when I got divorced. You used behavioral therapy? No. Electroshock. Works like a charm. Kidding! I'm just kidding. - I hate to interrupt. - Oh, yeah. Let's go upstairs and talk. - Nice meeting you. - You too. - We're losing him. - Any word on the DNR? - Not yet. - Found some weed in his socks. He's smoking dope with CF? Must be a death wish. They're paging Dr. Dobry. He's a pediatrician. How old is he? I told you, he's 19. to a pediatrician. How old? He's 17. ET tube! He's crashing! Should we restrain him? Yeah. Give him sux and Pav. I'm tubing him. Move his head. I'm sorry, Jad. It hit me really suddenly, so I'm gonna have to cancel. - Bless you. - He's not sick. He's blowing off a date. I'm gonna get to bed early. So I'll call you tomorrow? Bye, Pol. - What's wrong with Polly? - Don't start. - He had to make room for Heather. - So you got two on the line? Hi, Mark. I forgot Mr. Papillion's chart. That's a coincidence because I have it right here. A Freudian might say I forgot it on purpose. I was supposed to have dinner with a colleague and they canceled. - Are you free? - I'd love to. I'm all jammed up. But I'd really like to. Well, it's just an impulse. Probably another time. Great impulse. I'm having dinner with a friend. My accountant, Roy. But we could do drinks. - Are you sure? - Yeah. Meet down here at 6? I'll see you then. All right. Good. - Jerry, can we lose these boxes? - Busy boy. Pulse ox is up to 94. Prep for an extubation? Mother's out front. She'd have been here sooner, but her car was stolen. The one that's outside. You want to fill me in? We were going to Mexico. We were gonna get a beach place and be together until the end. The doctors gave him three months. Why can't you be together here? His mom wants to put him in the hospital. Is he all right? His airway was blocked, but we got it cleared. Thank God! Sweetheart, I was so worried. Katy, I knew you'd be here. Are you trying to kill him? He'd rather be dead than be with you. Katy, would you give us a minute, please? He wants me to stay. - Can we talk over here? - Yes. - I was taking the tube out. - Already? Well, his lungs are fairly clear and he wanted it out. Listen, he didn't want to be intubated. He said he had a "do not resuscitate" order? He lied. Look, he has this romantic notion about dying. I just needed to know that if he stops breathing again Intubate him. All right, Jad. Let me get this tube out for you. Now, I want you to do me a favor. I want you to take a deep breath. As deep as you can. Now blow hard. Blow, blow, blow! Don't ever tube me again. - Why are you taking our picture? - To keep track of the suspects. - Two swabs? - Nasal and rectal. - We need them back by 3. - God, I feel like a convict! The number matches your lab slip. I hope the doctors get the same treatment. They have to swab too. Staphylococcus does not discriminate. Smile, Wendy. Give me the bullet. Twenty-three-year-old IV drug user. Multiple GSWs. BP, 80 palp. Pulse, 140. Lost a liter at the scene. His buddy says he's got AIDS. Let's type and cross-match for six. - Get some O-neg here. - Taken care of. - I can run this one. - So can I. I'll run it. We'll start with the ABCs. - He's breathing from his mouth. - Pressure's falling. - Got the O-neg. - Run it through the transfuser. Intubation tray. He may have a hemopneumo. - You need help, Dr. Doyle? - No. - I got the film. - Clamp! Don't touch it! - What? - The bullet. Where you were about to stick your finger. He has AIDS. It's a Black Talon. The edges are like razors. I'll never find this thing. Oh, I don't believe it. It's right - Yeah, I got it. - He's arrested! Let's crack him. Want to do the honors? Second unit's in. - Anyone seen a nursing schedule? - You were in charge of it. I better have this weekend off. I've got National Guard duty. - God help us. - Has anybody seen the ultrasound? Everything's disorganized without Carol. I would try Exam 2. When's she coming back? We just hope she is coming back. We need some plasma. Suction! She can't see a thing here! - Bullet must have nicked an artery. - Satinsky. Intracardiac epi and calcium ready. This is jammed. I can't use it. I'll find another one. Put pressure on the lungs. Do compressions. - I'm squeezing. - No. That's me. Sorry. I got it. Good job, you two. Now, can you hold on while we take him upstairs? - Yeah. - Sure. Can I assist? - Your paperwork done? - Signed and in your box. Let's get him to the O.R., people. Come on, let's go! Look out. What's the ultrasound doing in there? I don't know. But that CF kid wants to talk to an Attending. All right, I'll be right there. Peter. - What are you doing? - Nothing. It must be something. When did the pains start? - Last night. - Location? Midepigastric. Shifted to the right lower quadrant this morning. Fever? Lie down. It's probably just a virus. Lie down. Lydia, can you assist? Dr. Benton? Just relax, Peter. Sorry. Alert the O.R. Dr. Benton has a hot appendix. Is it true what they say about? Hey, have you guys seen Doug? Try the Admit desk. What? Nothing. Hey, Doug. You busy? What's the recommended antibiotics for end-stage cystic fibrosis? I'm sorry. So I took your advice, and I canceled with Polly. - Good. - And then I met Nina. Now it's drinks with Nina, then basketball with Heather. Great. Should I have Heather meet me at the stadium? I could spend more time with Nina. I'm busy with a sick kid. Can we talk later? Yeah, yeah. Sure. I'll catch you later. Hey, Mark. That's a tough case. You know, that kid with end-stage CF. If he had a jacks ball in his throat, maybe I could fix it. You know he wants to be made DNR. - You talked to him? - Yes. He's my patient. He spoke to me. Maybe you haven't been listening to him. He's 17. It's his mother's decision. He'll be 18 in three weeks. So maybe we should consider his feelings. He's a teenager. He's mixed-up. He ran away from home. He's terminally ill and doesn't wanna be on a respirator. I can't go along with letting him die. Whose problem is this? His or yours? Oh, my God! It's true. I thought the nurses were kidding. Dr. Hicks, I don't want any residents operating on me, okay? Don't worry. It's just your average run-of-the-mill appendectomy. - So you'll do it, right? - I'll be there. I better go scrub. Sign this consent form. Dr. Hicks'll answer any questions. That won't be necessary. All right. Come on. Let's get this thing over with. Okay, time to prep. Raise your gown. - It's a mystery. - Doesn't add up. Here are the patients with staph. None were treated by the same doctor. Where's the missing link? We could put cameras in the bathroom to see who doesn't wash their hands. - Wait a minute. - What? All these charts have the same handwriting on top. You recognize it? Greg. Jeanie. Dr. Fischer. Can I offer you guys a brownie? No, thanks. What? Is something wrong? - What are you doing? - Scrubbing in. Dr. Hicks said I could help out on that thoracotomy. You're interested in surgery? I've been thinking about doing an elective. Thank you again for warning me about that bullet. My dad's a cop. We talked ammo at the dinner table. Seriously? You should see my collection. I got a Beretta.687, Winchester Golden Quail. And I got a Tommy gun that belonged to Dillinger. Change in plans. Simon's got the gunshot. We're doing the appy. The appy? Disappointed? Yeah, they're kind of boring. You haven't seen the patient yet. Oh, there is a God. What are my chances of getting out of here? I can't say. Don't give me that crap. You still have some time. Three months, max. You could spend that time with Katy. Great. She can suction the snot out of my lungs while I stare at the ceiling. I've been in hospitals my whole life. I watched two friends die on a respirator slowly wasting away. No, thanks. It's not your decision. Oh, please. I'll be 18 in three weeks. - Can't do it. - Screw you! What about me? It's up to your mom. She's been telling me what to do my whole life. For once, let me do what I want. You know, she's afraid of losing you. She's gonna lose me anyway. Talk to her. Tell her to let me go. Hey, look who it is! - Why are you here? - Pick up my paycheck. Not here yet. Thanks for taking our side against management. I guess you're paying for it. - Why are all these boxes here? - Procurement screwed up. Oh. Some fool ordered by the gross, huh? - Here's my paycheck. - Any idea when you're coming back? No. The hearing's in a few weeks though, so We've missed you. Thanks. Well, I'm off to Pottery Barn. Gonna go buy some candles. See you. Someone order some hypodermics? This is ridiculous. I do not need hand-washing lessons. Scrub hard to scrape off the bacteria. And wash your hands after you go to the bathroom. What, every time? - You have the Roux retractor? - Yes, Peter. And the Army-Navys and the Kocher. Listen, listen. Make sure you put an "X" on my right side. I don't want you taking out my left kidney. We're putting you to sleep now. Where's Dr. Hicks? There's been a last-minute substitution. Carter? Don't worry, Dr. Benton. I'll take very good care of you. He hates me. I know he loves me, but he also hates me. Is he an only child? After he was diagnosed, we decided not to risk passing it on. I spoke to Jad. He wants you to sign his DNR papers. Of course he does. He's got a pretty convincing argument. He just wants to hurt me. I don't think that's true. Shouldn't you give him a chance to make this decision? He's almost 18 years old. He was a beautiful baby, Dr. Ross. When the doctors told us that he had cystic fibrosis it was like somebody plunged a knife into my heart. And now he's grown up. He wants to take control of his life and he doesn't want to die hooked up to a respirator. And you agree with him. He doesn't have much time left. It seems a shame to spend it fighting with your son. I don't know what to do. Well, he does. How are we doing on the board? Actually, there's a psychotic wrestler in 2. Want me to page a certain Psych consult? That's an excellent idea. Hey, sweet pea! You poor thing. Working while you're sick. Polly, I can't talk. I've got laryngitis. Elderberry extract. It's homeopathic. It cleared my flu right up. Thank you. Excuse me. Cancel that page. You should go. I don't want you to catch it. Not until I make you an herbal steam of lavender for your throat. Jerry, we'll be in the lounge. - Shirley? - Yes, sir. - Would you put on my special music? - Certainly, sir. Scalpel. Hold it, Dr. Carter. Shirley? Let's get this one. Let's get one with Dr. Hicks and Dr. Doyle. What's your approach? I am going to make a minimal Rocky-Davis incision in the right lower quadrant. Proceed. Come on, inhale. It won't work unless you breathe it in. Excuse me, Dr. Greene. Your psychiatrist is at the desk. I'll be right back. I told you to cancel. The page went through. I'm sorry. Did you page me? Yeah. We have a patient in 2 who needs evaluating. - I'm looking forward to this evening. - Me too. Dr. Greene to the front desk, please. Emergency at the front desk. - I'll see you at 7. - Six. Right. My brother got us courtside seats. I was so excited, I came by. Terrific. - We could get a bite before the game. - I've got that meeting. Safety Committee? - Could I meet you at the stadium? - How about afterwards? We should talk, but I'm swamped. That's okay. I'll just have a seat. You know what? You don't want to sit in there. There's this staph infection that's going around. Why don't you sit over here? Yeah, yeah. This is fine. I'll be right back. You really shouldn't be on your feet. Polly, why don't you go back and keep that lavender steaming? Thanks. That is a very interesting case. He's diagnosed with multiple personality disorder. - Really? - Are you okay? Nina? Polly? I haven't seen you in a blue moon. You practiced at Northwestern? I did. Are you at the gallery? I sure am. Mark, this is Polly MclKenzie. My old friend, Polly, Mark Greene. I know. Mark and I are seeing each other. We were supposed to have dinner tonight, but he's got the flu. Funny. I thought we were having drinks. Gee, was that drinks before or after the basketball game? You're not sick. No, but I'm starting to feel a little nauseous. - Did he spike a fever? - 5 minutes ago. Get blood cultures. - I'll get the intubation tray. - No. His mother signed a DNR order. How are you doing, buddy? Good. Remember doctor Put an O-2 mask on him. Are you sure? - His mom? - In the cafeteria. Get her now, will you? Go! Could you turn that down? Just a bit. I'm ready to close. Nice work. Thanks. Maybe I'll staple my name into his belly. Let's irrigate one more time. We don't want to give Dr. Benton an abscess. Dr. Doyle, you want to suction out Dr. Benton? Can I have O-PDS on a CT-3? I'll close out with a running stitch. You ever done a one-handed tie? I often practice on pigs' feet. But since Dr. Benton is available Hold the suture in your left hand. And don't let go. You take it between your thumb and your forefinger around and through. Pretty nifty. Can Dr. Doyle try one? Dr. Benton wouldn't mind. After all, we are a teaching hospital. - Thanks. - Thanks for all your help today. We make a good team. Maybe we should go out again. - I don't think so. - It'd be fun. - It's not a good idea. - Come on. Dinner. Let's keep it professional. His pulse ox is falling. 83. - What happened? - He's in respiratory failure. I'm here, sweetheart. Sweetie. - He's stopped breathing. - Oh, my God! Oh, God. I can't watch this. - Intubate him. - Yeah, please. No. We promised. - Mrs. Heuston - Do it! No, no, Mrs. Heuston. You signed the paper. Well, then rip up the paper! Just do it! I said, do it! Sorry. Intubation tray. Hold him down. Fifty of sux. We'll have to paralyze him. Hold him down. Number 8 ET tube, please. Take it. Bag him. He's tubed. I feel like such a klutz. - Lots of people fall off stepladders. - I fell over one. I was hanging a picture. I took three steps back and landed on my ass. - You're lucky. - I guess. - I bet you don't remember me, do you? - Should I? I was in here about a year ago. I weighed 40 pounds less. I had pneumonia and almost died. You took care of me. You have AIDS. I was set to die. I said goodbye to everyone. I got rid of my stuff, cashed in my life insurance. - Then everything changed. - Really? You've heard of the cocktail? My doctor put me on it. I haven't felt this good in a long time. That's great. It's weird. It's like I was on death row, and the governor called. It takes a little getting used to but it is a hell of a lot better than dying. Peter, I'm pregnant. I'm pregnant. Dr. Benton I'm pregnant. There we go. Your surgery was a complete success. You had an acute suppurative appendicitis with no complications. Here's your appendix. Don't try and talk. You're coming out of the anesthesia. I really screwed up. - I really did. - You did? I never gave the kid a chance. Carla, I'm so sorry. - I don't know what to do. - No. It's me, Carter. What's going on? You're in the Recovery room. I just took out your appendix. You want me to call Carla? You were asking about her. What else did I say? That you screwed up. That you regret treating me so badly. That if you could change things, if you could do it over again - I was just coming up to see you. - Really? Did you settle things with Polly and? Was it Heather? I apologize. I was a real jerk today. I wanted to make it up to you. Are you free Tuesday? Great. That's the night of my sex addicts and compulsive liars therapy group. I've never acted like this before. I'm really sorry about what happened. Maybe we could have lunch. Maybe. In the meantime, whenever you have an urge to date three women at once snap it. I hope I'm not disturbing you. What's on your mind? I'll take you up on your offer. For dinner? How about tonight? Sounds good. Do you like zabaglione? Should I? I know a great Italian place. Transfer papers on the Heuston boy. ICU got a bed? Yeah, they're moving him now. Thank you, Dr. Ross. Thanks. I'm sorry. Can I get a couple bottles of lidocaine? You still here? I thought you had a date. - Canceled. - They busted you? They busted me. Men are so stupid. How many women did you date when you were with me? - Just you. - Really? Except for that night that my neighbor broke up with her boyfriend. - I had to comfort her. - So that was a public service. - Other than that, I was faithful. - I feel blessed. - I still have dinner reservations. - Where? La Soir Áe. You never took me to La Soir Áe. Well, just an oversight which I would like to correct. I'll have to take a look at my calendar. What are you doing? - Practicing one-handed sutures. - What's that? An eggplant. - Did they run out of pigs' feet? - I'm a vegetarian. You doing anything later? Actually, I got plans. Well, maybe some other time. If you want, you could come with me. Yeah. I'd love to. Where? How could you forget about our timecards? - I didn't forget. - Then why didn't we get our paychecks? I don't know. Someone in Administration must have screwed up. I distinctly remember collecting all the timecards wrapping them up and then stuffing them in my purse Good, but you're supposed to hit your own target. Might want to keep your eyes open this time. Let me show you. Relax. The trick is to caress the butt and squeeze the trigger slowly - Oh, my God! - What? - Over there. - Where? Maybe she won't see us. - That woman in the red sweater. - The tall one? - Don't look. - Why? That's my ex-girlfriend, Amy Elliott. - Girlfriend? - Cop. I broke up with her two months ago. She's jealous as hell. - More champagne? - Are you trying to get me drunk? Yeah, I need the company. So you lost all three, right? I told you. - And your day? - I don't wanna talk about it. So what do you want to do after dinner? We could see a movie. Go bowling. I forgot. Let's just get more champagne. I like that idea. I had a really nice time. I hope it is the first of many. There's my car. Wanna get some coffee? I know a great place. It's getting late and I gotta work early tomorrow. That's the real reason? Well, I'm afraid. Of what? Of liking you too much. What's wrong? Nobody's done that in a really long time. Aren't you afraid?